Provider Demographics
NPI:1407870512
Name:REINMUTH, KARL SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:SCOTT
Last Name:REINMUTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3550
Mailing Address - Country:US
Mailing Address - Phone:509-494-6700
Mailing Address - Fax:509-573-6275
Practice Address - Street 1:102 E 2ND ST
Practice Address - Street 2:
Practice Address - City:NACHES
Practice Address - State:WA
Practice Address - Zip Code:98937-9743
Practice Address - Country:US
Practice Address - Phone:509-653-2235
Practice Address - Fax:509-653-2236
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00038321207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8253122Medicaid
WAP00426693OtherMEDICARE RAILROAD
WA0184952OtherLABOR & INDUSTRIES
WAAB33735Medicare PIN
WA8253122Medicaid
WAAB38059Medicare Oscar/Certification